Mandibular morphometric analysis in open bite early treatment relapse subjects: a retrospective observational pilot study

Background: The purpose of this retrospective study was to evaluate the mandibular shape differences between a group of success and a group of failure Anterior Open Bite (AOB) malocclusion early orthodontic treatment in growing subjects, in order to identify mandibular features of relapse. Methods: Twenty three patients (7 males, 16 females, 9.3 years ±1,5 years) were enrolled from the Department of Orthodontics at the University of Rome Tor Vergata. Inclusion criteria were: white ancestry, overbite < 0 mm, mixed dentition phase, end-to-end or Class I molar relationship, first skeletal class assessed on lateral cephalograms (0° < ANB < 4°), cervical skeletal maturation CS1-CS2, no previous orthodontic treatment, no congenital diseases. Pre-treatment (T1) lateral cephalograms were acquired. Each patient underwent early orthodontic treatment with Rapid Maxillary Expander (RME) and Bite Block (BB) or Quad-Helix Crib (QHC) until open bite correction. Radiographic records were recollected at T2 (permanent dentition, skeletal cervical maturation CS3-CS4). Mean interval time T2-T1 was 4.2 years ±6 months. According to treatment stability, a Relapse Group (RG 11 patients, 3 M, 8F; 13.7 years ±8 months, 7 subjects treated with RME/BB, 4 with QH/C) and a Success Group (SG, 12 patients, 4 M, 8F; 13.4 ± 10 months, 7 subjects treated with QH/C, 5 with RME/BB) were identified. On the lateral radiographs the mandibular length (Co-Gn), the inferior gonial angle (NGo^GoMe) and the antegonial notch depth (AND) were analyzed. Then the mandibular Geometric Morphometric analysis (GMM) was applied. Intergroup statistically significant differences were found using student's t-tests. Procrustes analysis and principal component analysis (PCA) were performed for the GMM. Results: At T1 no statistically significant differences were found between RG and SG, however higher values of antegonial notch depth were found in RG. T2-T1 comparison showed in RG statistically significant increases in Co-Gn (p = 0.04), NGo^GoMe angle (p = 0.01) and antegonial notch depth (p = 0,04). PC1 confirmed the increase in the antegonial notch depth in RG when compared to SG at T2. Conclusions: The increased antegonial notch depth associated with the increased mandibular length and the increased gonial angle could be responsible of relapse of early orthodontic treatment in open bite growing subjects

Palatal vault morphometric analysis of the effects of two early orthodontic treatments in anterior open bite growing subjects: a controlled clinical study

Abstract Background The purpose of this study was to evaluate the palatal morphological changes in Anterior Open Bite (AOB) pre-pubertal subjects treated with Rapid Maxillary Expansion and Bite-Block (RME/BB) or Quad Helix with crib (QH/C) when compared with a Control Group (CG) by using Geometric Morphometric Analysis (GMM). Methods AOB group (AOBG) included 30 subjects (20 females, 10 males, mean age 8.1 ± 0.8ys) with dentoskeletal AOB. AOBG was divided in two subgroups according to the treatment strategy: RME/BB group (RME/BBg) included 15 subjects (10 females, 5 males, QH/C group (QH/Cg) comprised 15 subjects (10 females, 5 males). The two subgroups were compared with a CG of 15 subjects (10 females, 5 males) matched for sex, age, vertical pattern, and observation period. Digital upper dental casts were collected before treatment (T1) and at the end of the active treatment (T2). Landmarks and semilandmarks were digitized on dental casts and GMM was applied. Procrustes analysis and principal component analysis (PCA) were performed. Results At T2, RME/BBg when compared with QH/Cg evidenced no statistically significant differences. Instead, RME/BBg showed an increased maxillary transverse dimension and a decreased palatal depth when compared with CG. The comparison QH/Cg vs. CG demonstrated a slight transversal maxillary expansion. Conclusions RME/BBg showed significant changes in the transversal and vertical dimensions with a clear maxillary expansion and a decrease of the palatal depth when compared with QH/Cg and CG. QH/Cg showed a significant slight maxillary expansion and no variation in vertical and sagittal planes when compared with CG

The efficacy and predictability of maxillary first molar derotation with invisalign: a prospective clinical study in growing subjects

To analyze the derotation of maxillary mesio-rotated first permanent molars in subjects with Class II edge-to-edge dental malocclusion in mixed dentition treated with Invisalign Clear Aligners (CA). In total, 36 patients (16 males, 20 females, 9.9 ± 1.9 years) treated with CA are enrolled from the Department of Orthodontics. Inclusion criteria are the following: Caucasian ancestry, mixed dentition, molar Class II edge-to-edge, no tooth/craniofacial anomalies, no caries/periodontal diseases. Pre-treatment (T1) and post-treatment (T2) digital casts, and final ClinCheck representations (T2ClinCheck) are acquired. The Henry’s angle (HA) is used to assess maxillary first molars rotation. The molars with an HA > 11° are taken (53 teeth). Five measurements are performed at T1, T2, and T2ClinCheck: Henry’s angle (HA), mesiobuccal-expansion (MBE), distobuccal-expansion (DBE), mesiobuccal-sagittal (MBS), and distobuccal-sagittal (DBS). A paired t-test was used to compare T2-T1 and T2ClinCheck-T2. The T2-T1 shows a distal-rotation (difference −6.3°) with an expansion of 2.2 mm for MBE and 1.5 mm for DBE. At T2, the mesiobuccal cusps show a distal movement of 1.0 mm and the distobuccal cusps of 0.9 mm. The HA’s T2ClinCheck-T2 difference is −4.2°. In the sagittal plane, the difference is 0.9 mm for the MBS and 0.7 mm for the DBS. The expansion showed the highest predictability (60% HA, 52.6% MBS, and 56.25% DBS). The CA effectively produces an arch expansion and upper molars’ distal rotation. Upper molar derotation provides a 1 mm of gain in arch perimeter and occlusal improvement

Morphometric covariation between palatal shape and skeletal pattern in Class II growing subjects

Objectives To evaluate the patterns of covariation between palatal and craniofacial morphology in Class II subjects in the early mixed dentition by means of geometric morphometrics. Methods A cross-sectional sample of 85 Class II subjects (44 females, 41 males; mean age 8.7 years ± 0.8) was collected retrospectively according to the following inclusion criteria: European ancestry (white), Class II skeletal relationship, Class II division 1 dental relationship, early mixed dentition, and prepubertal skeletal maturation. Pre-treatment digital 3D maxillary dental casts and lateral cephalograms were available. Landmarks and semilandmarks were digitized (239 on the palate and 121 on the cephalogram) and geometric morphometric methods (GMM) were applied. Procrustes analysis and principal component analysis (PCA) were performed to reveal the main patterns of palatal shape and craniofacial skeletal shape variation. Two-block partial least squares analysis (PLS) assessed patterns of covariation between palatal morphology and craniofacial morphology. Results For the morphology of the palate, the first principal component (PC1) described variation in all three dimensions. For the morphology of the craniofacial complex, PC1 showed shape variation mainly in the vertical direction. Palatal shape and craniofacial shape covaried significantly (RV coefficient: 0.199). PLS1 accounted for more than 64 per cent of total covariation and related divergence of the craniofacial complex to palatal height and width. The more a Class II subject tended towards high-angle divergence, the narrower and higher was the palate. Conclusions Class II high-angle patients tended to have narrower and higher palates, while Class II low-angle patients were related to wider and more shallow palates

Genetic determinants in a critical domain of ns5a correlate with hepatocellular carcinoma in cirrhotic patients infected with hcv genotype 1b

HCV is an important cause of hepatocellular carcinoma (HCC). HCV NS5A domain‐1 interacts with cellular proteins inducing pro‐oncogenic pathways. Thus, we explore genetic variations in NS5A domain‐1 and their association with HCC, by analyzing 188 NS5A sequences from HCV genotype‐1b infected DAA‐naïve cirrhotic patients: 34 with HCC and 154 without HCC. Specific NS5A mutations significantly correlate with HCC: S3T (8.8% vs. 1.3%, p = 0.01), T122M (8.8% vs. 0.0%, p < 0.001), M133I (20.6% vs. 3.9%, p < 0.001), and Q181E (11.8% vs. 0.6%, p < 0.001). By multivariable analysis, the presence of >1 of them independently correlates with HCC (OR (95%CI): 21.8 (5.7–82.3); p < 0.001). Focusing on HCC‐group, the presence of these mutations correlates with higher viremia (median (IQR): 5.7 (5.4–6.2) log IU/mL vs. 5.3 (4.4–5.6) log IU/mL, p = 0.02) and lower ALT (35 (30–71) vs. 83 (48–108) U/L, p = 0.004), suggesting a role in enhancing viral fitness without affecting necroinflammation. Notably, these mutations reside in NS5A regions known to interact with cellular proteins crucial for cell‐cycle regulation (p53, p85‐PIK3, and β‐ catenin), and introduce additional phosphorylation sites, a phenomenon known to ameliorate NS5A interaction with cellular proteins. Overall, these results provide a focus for further investigations on molecular bases of HCV‐mediated oncogenesis. The role of these NS5A domain‐1 mutations in triggering pro‐oncogenic stimuli that can persist also despite achievement of sustained virological response deserves further investigation

SARS-CoV-2 omicron (B.1.1.529)-related COVID-19 sequelae in vaccinated and unvaccinated patients with cancer: results from the OnCovid registry

Background COVID-19 sequelae can affect about 15% of patients with cancer who survive the acute phase of SARS-CoV-2 infection and can substantially impair their survival and continuity of oncological care. We aimed to investigate whether previous immunisation affects long-term sequelae in the context of evolving variants of concern of SARS-CoV-2. Methods OnCovid is an active registry that includes patients aged 18 years or older from 37 institutions across Belgium, France, Germany, Italy, Spain, and the UK with a laboratory-confirmed diagnosis of COVID-19 and a history of solid or haematological malignancy, either active or in remission, followed up from COVID-19 diagnosis until death. We evaluated the prevalence of COVID-19 sequelae in patients who survived COVID-19 and underwent a formal clinical reassessment, categorising infection according to the date of diagnosis as the omicron (B.1.1.529) phase from Dec 15, 2021, to Jan 31, 2022; the alpha (B.1.1.7)-delta (B.1.617.2) phase from Dec 1, 2020, to Dec 14, 2021; and the pre-vaccination phase from Feb 27 to Nov 30, 2020. The prevalence of overall COVID-19 sequelae was compared according to SARS-CoV-2 immunisation status and in relation to post-COVID-19 survival and resumption of systemic anticancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974. Findings At the follow-up update on June 20, 2022, 1909 eligible patients, evaluated after a median of 39 days (IQR 24-68) from COVID-19 diagnosis, were included (964 [ 50 center dot 7%] of 1902 patients with sex data were female and 938 [49 center dot 3%] were male). Overall, 317 (16 center dot 6%; 95% CI 14 center dot 8-18 center dot 5) of 1909 patients had at least one sequela from COVID-19 at the first oncological reassessment. The prevalence of COVID-19 sequelae was highest in the prevaccination phase (191 [19 center dot 1%; 95% CI 16 center dot 4-22 center dot 0] of 1000 patients). The prevalence was similar in the alpha-delta phase (110 [16 center dot 8%; 13 center dot 8- 20 center dot 3] of 653 patients, p=0 center dot 24), but significantly lower in the omicron phase (16 [6 center dot 2%; 3 center dot 5-10 center dot 2] of 256 patients, p<0 center dot 0001). In the alpha- delta phase, 84 (18 center dot 3%; 95% CI 14 center dot 6-22 center dot 7) of 458 unvaccinated patients and three (9 center dot 4%; 1 center dot 9- 27 center dot 3) of 32 unvaccinated patients in the omicron phase had sequelae. Patients who received a booster and those who received two vaccine doses had a significantly lower prevalence of overall COVID-19 sequelae than unvaccinated or partially vaccinated patients (ten [7 center dot 4%; 95% CI 3 center dot 5-13 center dot 5] of 136 boosted patients, 18 [9 center dot 8%; 5 center dot 8-15 center dot 5] of 183 patients who had two vaccine doses vs 277 [ 18 center dot 5%; 16 center dot 5-20 center dot 9] of 1489 unvaccinated patients, p=0 center dot 0001), respiratory sequelae (six [4 center dot 4%; 1 center dot 6-9 center dot 6], 11 [6 center dot 0%; 3 center dot 0-10 center dot 7] vs 148 [9 center dot 9%; 8 center dot 4- 11 center dot 6], p= 0 center dot 030), and prolonged fatigue (three [2 center dot 2%; 0 center dot 1-6 center dot 4], ten [5 center dot 4%; 2 center dot 6-10 center dot 0] vs 115 [7 center dot 7%; 6 center dot 3-9 center dot 3], p=0 center dot 037)

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p &lt; .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p &lt; .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Movement of anterior teeth using clear aligners: a three-dimensional, retrospective evaluation

Abstract Background Clear aligner treatment offers several advantages, but the available literature shows that some kind of tooth movements are unpredictable. In addition, the majority of the studies are focused on one clear aligner system, while different characteristics of various systems can provide different treatment outcomes. The aim of the present retrospective cohort study was to evaluate the predictability of Nuvola® aligner system in achieving torque movements of anterior teeth. Methods Thirty-nine adult patients, who were consecutively treated with clear aligners, were retrospectively selected, and digital models pre-treatment (T0), post-treatment (T1) and the digital setup models (TS) were collected. Only the first phase of treatment made of 12 aligners was considered for the present study. Torque of anterior teeth was measured as labiolingual inclination on digital models at T0, T1, and TS using VAM software. Any difference between the predicted and achieved torque movements was evaluated using Wilcoxon signed-rank test or paired sample t test. First-type error was set as p < 0.008. Results No statistically significant difference was found for all the anterior teeth between predicted and achieved torque movements. Conclusions The studied clear aligner system was able to produce clinical outcomes comparable to the planning of the digital setup relative to torque movements of the anterior teeth